Have More Babies

🎙 Rickets: The Silent Threat to Your Child's Bones

• Michael Nwaneri, MD • Season 1 • Episode 76

Share episode

Send us a text

The silent return of rickets in modern children reveals a surprising gap in our understanding of essential childhood nutrition. Despite advances in healthcare and overall nutrition, this skeletal disorder—characterized by soft, weak, and potentially deformed bones—continues to affect children across all demographics.

Diving deep into the science of bone development, we explore how vitamin D serves as the critical "mortar" that allows calcium to properly strengthen growing skeletons. When this vital nutrient is missing, even calcium-rich diets fail to support proper mineralization. Our modern lifestyle, with decreased outdoor playtime and increased screen time, creates the perfect environment for vitamin D deficiency to flourish unnoticed until physical symptoms appear.

Certain groups face heightened risk factors that parents should know about. Children with darker skin tones require more sun exposure to produce adequate vitamin D due to protective melanin. Exclusively breastfed babies need vitamin D supplementation from the earliest days, as breast milk alone—while nutritionally superior in many ways—typically lacks sufficient vitamin D. We also share crucial early warning signs beyond the classic bow legs, including subtle developmental delays, unexplained weakness, dental issues, and growth concerns that might otherwise be overlooked.

Prevention remains the gold standard approach, and we provide actionable strategies for parents at every stage of childhood. From specific supplementation guidelines for infants to balanced nutrition approaches for growing kids, these evidence-based recommendations from pediatric experts at Omega Pediatrics offer a practical roadmap for ensuring strong skeletal development. By recognizing the risks and taking proactive steps, we can protect our children from this entirely preventable condition. Listen now to gain the knowledge that could make all the difference in your child's long-term health and development.

Visit the blog post: https://www.omegapediatrics.com/the-unbelievable-truth-about-rickets/

🎧 Thanks for Listening!

If you found this episode helpful, be sure to subscribe, download, and share it with friends, family, or colleagues who might benefit. Your support helps us reach more listeners and spread valuable knowledge on pediatric care.

🌐 For more expert insights, resources, and services, visit Omegapediatrics.com — your trusted source for compassionate, comprehensive pediatric care.

💬 Have questions or ideas for future episodes? Leave us a comment or message us through our website — we’d love to hear from you!

📲 Follow us on social media for tips, updates, and behind-the-scenes content.

Stella:

Welcome to have More Babies. I'm Stella, and today, well, we're diving into something really crucial. It's not about population numbers, but something vital for the health of those babies Rickets. You might think you know it's an old disease, but surprisingly it's still a concern, even here.

Matthew:

That's absolutely right. Rickets is a skeletal disorder. Basically, children's bones don't develop correctly. They can become soft, weak, even deformed.

Stella:

Yeah.

Matthew:

And, yeah, what's surprising is that it's still around Understanding why is well, it's key to prevention.

Stella:

Totally agree. And for this deep dive, we're using info from the pediatric experts at Omega Pediatrics. Our goal today to really unpack this condition. What is it, what pauses it, what signs to look for? And, yeah, goal today to really unpack this condition. What is it? What causes?

Matthew:

it. What signs to?

Stella:

look for and, yeah, how to prevent it. Crucial stuff it really is. So let's start right there. What's?

Matthew:

actually happening inside a child's body with rickets. Okay, so, fundamentally, rickets messes with how bones mineralize, how they harden. Think of it like you have the bricks, the building blocks for bones, but the mortar isn't working right, ah, okay.

Stella:

So they don't assemble properly for bones. But the mortar isn't working right. Ah, okay, so they don't assemble properly, leading to softer bones.

Matthew:

Exactly Softer, weaker structures that can bend or get misshapen, so the bones just aren't hardening like they should. That's it in a nutshell and the main reason the primary driver.

Stella:

It's a lack of vitamin D. Vitamin D, right. We hear so much about that. Is it only vitamin D, though, or are there other factors?

Matthew:

It's definitely the biggest one by far, but it's worth remembering that not having enough calcium or phosphate minerals themselves can also play a role. It's just well less common as the main cause these days, especially in developed areas.

Stella:

It still feels, I don't know, kind of remarkable that a condition like this persists, even with modern medicine. Why is that Remarkable, that a condition like this persists even with modern medicine.

Matthew:

Why is that? Well, it's interesting, isn't it? Even with better health care access, maybe better nutrition overall, our modern lifestyles can create gaps. Think about kids, maybe spending less time playing outside, you know, less sun exposure in some places.

Stella:

That makes a lot of sense. Ok, so let's zero in on vitamin D for a bit. Why is it so incredibly important for kids' bones?

Matthew:

Okay. So vitamin D has this absolutely critical job. It lets the body absorb calcium from food. You can eat loads of calcium-rich foods, but if you don't have enough vitamin D, your body just can't use the calcium effectively. Exactly. It's like trying to build that wall we talked about, but having no mortar for the bricks. The calcium is there, but it can't become part of the bone structure properly.

Stella:

That's a really clear analogy. So how does a kid actually become deficient in vitamin D? What are the usual ways?

Matthew:

Well, there are a few main paths. Number one is not enough sunlight, simple as that. Sometimes Our skin makes vitamin D when it's exposed to UVB rays from the sun.

Stella:

Right.

Matthew:

So if you live somewhere with less sun, maybe during winter, or if kids are mostly indoors, their vitamin D production just drops significantly sometimes.

Stella:

Okay, less sun exposure. What about diet? Does that play a big role?

Matthew:

Oh, absolutely Not getting enough vitamin D through food is another major con.

Stella:

Yeah.

Matthew:

If a child's diet is low in things like, say, fatty fish Exactly, and while some foods are fortified, like milk or some cereals, the levels might not always be enough on their own, especially for infants who aren't eating a wide variety of foods yet.

Stella:

So sunlight and diet are the big two. Any other ways deficiency can happen.

Matthew:

Yes, though it's less frequent. Certain medical conditions can interfere with nutrient absorption things we call malabsorption issues. That can also lead to low vitamin D.

Stella:

Okay Now. We mentioned vitamin D as primary, but you also brought up calcium and phosphate. How do they fit into the Ricketts picture if they're deficient?

Matthew:

Right. So while it's less often the main cause in places with fortified foods, calcium and phosphate are literally the minerals that make bones hard and strong. So if a child isn't getting enough through diet, or again if their body struggles to absorb them, that can also result in the weakened bones we see in rickets.

Stella:

So it's really a team effort between these nutrients for healthy bones.

Matthew:

You could say that yeah.

Stella:

Now thinking about prevention and awareness. Who should be most vigilant? Are there specific groups of children at higher risk?

Matthew:

That's a really important question. Definitely, like we said, kids in areas with limited sun exposure. That's a big one. Also, infants and children with darker skin tones.

Stella:

Why is that?

Matthew:

Well, the melanin in darker skin. It's protective against sun damage, but it also reduces the skin's ability to produce vitamin D from sunlight, so they need more sun exposure to make the same amount.

Stella:

That's really vital information for parents. What other risk factors should we know about?

Matthew:

Another key one is exclusive breastfeeding without giving the baby vitamin D supplements. Breast milk is amazing, obviously, but it often doesn't contain enough vitamin D for the baby's needs, especially if the mother herself is low in vitamin D.

Stella:

Wow, okay, that's crucial for new parents to hear. So knowing the risks is step one. What about the actual signs? What should parents be looking out for?

Matthew:

Yeah, this is where catching it early is so important. One of the clearest signs can be bone deformities. You might notice bull legs where the legs curve out, or knock knees where the knees angle inwards.

Stella:

Those sound quite visible. Are there subtler signs? Maybe earlier on?

Matthew:

Yes, definitely, muscle weakness can be an early clue, maybe a delay in hitting motor milestones like sitting up, crawling, walking, or the child might just seem weaker or tire out more easily than other kids their age.

Stella:

Okay, so developmental delays could be linked, anything else?

Matthew:

Dental problems can show up too, things like teeth coming in late, or maybe more cavities than you'd expect and just generally slower growth. The child might not be keeping up on the growth charts.

Stella:

So it's potentially a mix of physical things, development, even dental health. It sounds like recognizing these signs early is really the key.

Matthew:

Absolutely. The earlier Ricketts is diagnosed and treated, the less chance there is of serious long-term bone problems.

Stella:

Okay. So if a parent sees some of these signs and is concerned, what happens next? How do doctors typically diagnose it?

Matthew:

Well, the process usually involves a few things. Blood tests are pretty standard. They'll check the levels of vitamin D, calcium and phosphate.

Stella:

Right getting those direct measurements, what else?

Matthew:

X-rays are also really useful. They can show changes in the bones like lower density or the specific deformities associated with rickets. And, of course, a good physical exam by a pediatrician is key. They'll assess the child's overall health and look for those signs we've been talking about.

Stella:

Makes sense A combination of tests and observation, and look for those signs we've been talking about. Makes sense A combination of tests and observation Once it is diagnosed, what's the treatment plan usually look like?

Matthew:

The main treatment is basically getting those nutrient levels back up, so supplementation with higher doses of vitamin D and calcium is usually the first step. The doctor figures out the right dose based on the child's age, how severe the deficiency is, things like that.

Stella:

Following their guidance is really important, so boosting those nutrients is central.

Matthew:

Does diet play a role in treatment too? Yes, dietary changes help support recovery, so encouraging foods rich in vitamin D, those fatty fish, eggs, fortified foods we mentioned, becomes even more important.

Stella:

And what about sunlight during treatment?

Matthew:

Moderate sun exposure can definitely help the body make its own vitamin D, but you have to be careful Too much sun isn't good either.

Stella:

Right Sun safety first.

Matthew:

Exactly. The pediatrician can give advice on finding that safe balance as part of the overall plan.

Stella:

Okay, so treatment tackles the deficiency directly, but ideally we want to stop it from happening at all. Right, prevention.

Matthew:

Absolutely. Prevention is always, always the best strategy and there are definitely proactive steps parents can take.

Stella:

Let's talk about those. What should parents focus on right from the start?

Matthew:

can take. Let's talk about those. What should parents focus on right from the start? Well, ensuring a balanced diet with enough vitamin D, calcium and phosphate is just fundamental all through childhood. It really starts even before birth with good maternal nutrition and continues as kids start solids.

Stella:

And specifically for infants. We mentioned breastfeeding.

Matthew:

Yes, this is where that vitamin D supplementation for exclusively breastfed babies comes in. It's really standard guidance. Now. The American Academy of Pediatrics recommends a daily supplement right from the first few days. Formula usually has vitamin D added, but it's always good to check with the doctor.

Stella:

So supplements are often needed for breastfed babies. What about older kids and preventing rickets? Sunlight again.

Matthew:

Yeah, encouraging regular but safe outdoor play is great for older kids. Helps the bodies make vitamin D naturally.

Stella:

Safe being the key word.

Matthew:

Definitely Moderation, sun protection and, of course, continuing that focus on a diet with plenty of vitamin D and calcium sources as they grow.

Stella:

This has been incredibly helpful and it's good to know there are experts focusing on this. We mentioned Omega Pediatrics earlier. Where can listeners find them if they're in the area?

Matthew:

Right yeah, omega Pediatrics has several clinics in the northern Atlanta suburbs, places like Roswell, alpharetta, milton, marietta and also down in Riverdale, georgia. They offer a whole range of pediatric care and they really emphasize preventive health and education. That sounds great yeah, if you're in that part of Georgia, they're a great resource. You can find out more on their website, omegapediatricscom.

Stella:

Omegapediatricscom. Good to know. Okay, so wrapping things up, what's the main message, the key takeaway you want people to leave with?

Matthew:

I think the most important thing is just understanding what rickets is, knowing the risks, recognizing the signs and, crucially, taking those preventive steps. It's all about protecting healthy bone development.

Stella:

That knowledge really empowers parents and caregivers it really does empower you and it makes you think, doesn't it, how things that seem quite simple, like getting enough Sun or specific vitamins, can have such a huge long-term effect on a child's health it absolutely does.

Matthew:

Yeah, it kind of leaves you with a question, doesn't it? How can we best support our kids' nutritional needs right from the start, to give them that solid foundation?

Stella:

That's a powerful thought to reflect on and hey, for everyone listening. If you found this useful, please, please share it. Tell other parents, other caregivers, help get this important information out there. Yeah, subscribe to have More Babies. Download the episodes. We'll be back with more deep dives into essential health topics when you share and come back. You're really building this community of informed parents and learners.

Matthew:

Absolutely Sharing knowledge is key.

Stella:

Thank you so much for sharing your expertise today. This was really valuable. Until next time on, have More Babies. Goodbye.

Matthew:

Goodbye, everyone, take care.

People on this episode

Head Shot

Michael Nwaneri, MD

Host